Home and Community-Based Services Final Rule Statewide Transition Plan

In January 2014, the Centers for Medicare & Medicaid Services (CMS) published regulations to better define the settings in which states can provide Medicaid Home and Community-Based Services (HCBS). The HCBS final rule became effective March 17, 2014. The HCBS settings final rule, along with additional guidance and fact sheets, is available on the CMS Home and Community-Based Services site.

The purpose of these regulations is to ensure that members receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources and receive services in the community to the same degree as individuals who do not receive HCBS. CMS expects all states to review current HCBS programs and to develop a transition plan providing an assessment, strategies and timelines for compliance with the new rules.

The programs currently under review include 1915(c) HCBS Waivers and 1915(i) HCBS State Plan programs operated by the following divisions within the Family and Social Services Administration.

Division of Aging

Division of Disability and Rehabilitative Services

Division of Mental Health and Addiction

Youth programs

Adult programs

Statewide Transition Plan

The Indiana Family and Social Services Administration (FSSA) has created a Statewide Transition Plan (STP) to assess compliance with the HCBS Settings Final Rule and identify strategies and timelines for coming into compliance with the new rule as it relates to all FSSA HCBS programs. Indiana’s initial STP was submitted to CMS for review and approval in December 2014. In September 2016, FSSA submitted a third version of the STP incorporating site-specific assessment results for Indiana’s HCBS programs. A fifth version with technical corrections was submitted to CMS which received initial approval on November 8, 2016.

In May 2017, CMS extended the implementation date of the HCBS Settings Final Rule to March 17, 2022, to allow states additional time to come into full compliance. Indiana submitted version seven of the STP to CMS on September 29, 2017. On December 1, 2017, CMS requested technical corrections for consideration of final approval. Per a directive from the Secretary, Indiana paused efforts towards becoming compliant with the final rule to allow all divisions an opportunity to regroup to better reflect the partnerships between FSSA, other agencies, and key stakeholders, including CMS, and to better understand how to meet our members’ needs. Indiana resumed efforts towards compliance on May 1, 2018, and is planning to submit version eight of the STP to CMS in October 2018 after the completion of the public comment period. In response to previous public comment, version eight is provided with redline corrections to assist in stakeholder review. All technical correction versions are located below.

Transition plan



Public Comment

The public comment period for Statewide Transition Plan: version eight, will run from August 22, 2018, to September 21, 2018. All comments must be received during this period. Copies of the updated Statewide Transition Plan: version eight, will also be made available at local DFR offices and at the address listed below.

Written comments may be sent via email to: HCBSrulecomments@fssa.in.gov or by mail to:

State of Indiana
Family and Social Services Administration
Office of Medicaid Policy and Planning
Attn: HCBS Final Rule – Joshua Bougie, Senior Manager of Program Development
402 W. Washington St., Rm. W374 MS-07
Indianapolis, IN 46204-2739